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Dr. Greg Vigna
Evaluating hospital-acquired and nursing home-acquired decubitus ulcers and the care offered at LTACs
Plastic surgeons are necessary for patients to receive a meaningful consultation as to the pros and cons of reconstructive surgery versus conservative options.” - Greg Vigna, MD, JD
SANTA BARBARA , CA, UNITED STATES, December 5, 2024 /EINPresswire / --“We describe treatments and outcomes of hospitalized patients with decubitus ulcer-related osteomyelitis who did not undergo surgical reconstruction or coverage... 44% patients were readmitted due to complications from osteomyelitis, and 17% died," states Laura Damioli, MD. Therapeutic Advance in Infectious Disease. Volume 10, pg. 1-9. 2023.
Greg Vigna, MD, JD, national decubitus ulcer attorney explains,“As a medical director of a Long-term Acute Care Hospital (LTAC), I developed a flap program because flaps offered a cure for patients admitted to the hospital with Stage III and Stage IV sacral, ischial, and/or hip decubitus ulcers. The opinion of Dr. Damioli supports my opinion that I had twenty-four years ago when I developed a flap program at an LTAC in Northern Louisiana, which is that patients with deep Stage III and Stage IV decubitus ulcers are at substantial risk of death.”
What did the study say?
1)“We describe treatments and outcomes of hospitalized patients with decubitus ulcer-related osteomyelitis who did not undergo surgical reconstruction or coverage.
2) Of 89 patients meeting inclusion criteria, 34 (38%) received surgical debridement and greater than 6 weeks of antibiotics; 55 (62%) received either antibiotics alone or debridement and less than 6 weeks of antibiotics. The mean age was 55.
3) Within 1 year, 56 (63%) patients were readmitted, 38 (44%) patients were readmitted due to complications from osteomyelitis, and 15 (17%) died.
4) We found no significant differences in readmission related to osteomyelitis, subsequent sepsis, or death by treatment group.”
What was the conclusion of the study?
1)“Among patients with decubitus-related osteomyelitis who did not undergo myocutaneous flapping, outcomes were generally poor regardless of treatment, and not significantly improved with prolonged antibiotics.”
Dr. Vigna continues,“The ongoing advertising by Long-Term Acute Care Hospitals for 'specialized wound care' that don't offer plastic surgery consultation and the opportunity for flap reconstruction for a patient with sacral, ischial, and hip decubitus ulcers must end because it is ineffective care according to this study, and it is deceptive. Patients who have suffered from Stage III and Stage IV decubitus ulcers with or without osteomyelitis need to be at LTACs with the medical staff that can best help them. There is a 17% risk of death for those who are not treated for cure with flap coverage, and there is a 44% risk of readmission due to complications related to osteomyelitis.”
Dr. Vigna continues,“There are many LTACs that advertise 'specialized wound care' that don't have the adequate medical staff, including a plastic surgeon, who have the skills to provide flap closure. Plastic surgeons are necessary for patients to receive a meaningful consultation as to the pros and cons of reconstructive surgery versus conservative options. These are serious medical conditions, and patients need to be directed to an LTAC that offers surgical treatment for cure.”
Dr. Vigna adds,“Skilled nursing homes can provide the Clinitron beds, IV antibiotics, and VAC packs at a large discount compared to LTACs. Advertising a specialized wound care program that doesn't offer reconstructive surgery is deceptive because the outcomes, according to this recent study, are 'generally poor'. The death rate of Stage III and Stage IV decubitus managed with conservative care without an attempt at closure is nearly one in five at one year.”
Dr. Vigna concludes,“We are evaluating hospital-acquired and nursing home-acquired decubitus ulcers and the care offered at LTACs. We are also evaluating ineffective care that is destined to fail provided at LTACs for those who suffer Stage III and Stage IV decubitus ulcers will be scrutinized.”
Greg Vigna, MD, JD, is a national malpractice attorney and an expert in wound care. He is available for legal consultation for families and patients who have suffered decubitus ulcers due to poor nursing care at hospitals, nursing homes, or assisted living facilities. The Vigna Law Group , along with Ben C. Martin, Esq., of the Ben Martin Law Group , a Dallas, Texas national pharmaceutical injury law firm, jointly prosecute hospital and nursing home neglect cases that result in bedsores nationwide.
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Greg Vigna, MD, JD
Vigna Law Group
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MENAFN provides the information “as is” without warranty of any kind. We do not accept any responsibility or liability for the accuracy, content, images, videos, licenses, completeness, legality, or reliability of the information contained in this article. If you have any complaints or copyright issues related to this article, kindly contact the provider above.